ObjectiveThe aim of the present study was to determine whether aerobic exercise involving an active video game system improved asthma control, airway inflammation and exercise capacity in children with moderate to severe asthma.DesignA randomized, controlled, single-blinded clinical trial was carried out. Thirty-six children with moderate to severe asthma were randomly allocated to either a video game group (VGG; N = 20) or a treadmill group (TG; n = 16). Both groups completed an eight-week supervised program with two weekly 40-minute sessions. Pre-training and post-training evaluations involved the Asthma Control Questionnaire, exhaled nitric oxide levels (FeNO), maximum exercise testing (Bruce protocol) and lung function.ResultsNo differences between the VGG and TG were found at the baseline. Improvements occurred in both groups with regard to asthma control and exercise capacity. Moreover, a significant reduction in FeNO was found in the VGG (p < 0.05). Although the mean energy expenditure at rest and during exercise training was similar for both groups, the maximum energy expenditure was higher in the VGG.ConclusionThe present findings strongly suggest that aerobic training promoted by an active video game had a positive impact on children with asthma in terms of clinical control, improvementin their exercise capacity and a reductionin pulmonary inflammation.Trial RegistrationClinicaltrials.gov NCT01438294

IntroductionPulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance.Patients and methodsPatients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20).ResultsThere were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR.ConclusionA program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log.

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Background: Obesity can affect the thorax, diaphragm and abdominal muscles, thereby resulting in altered respiratory function. Objective:To evaluate the effects of obesity and to determine whether body mass index (BMI) and waist circumference correlate with spirometry values in obese individuals. Methods:We studied 96 non-smokers of both sexes, all suffering from class I or class II obesity and ranging in age from 18 to 75. All participants presented a BMI between 30 kg/m 2 and 40 kg/m 2 and none had a history of morbidity. Spirometry was performed, and waist circumferences were measured.Results: No significant differences were found between the spirometric values of men with class I or II obesity and those of non-obese men. In obese women, forced vital capacity and forced expiratory volume in one second (FEV 1 ) were significantly lower than in women who were not obese. Obese individuals of both sexes presented significantly lower expiratory reserve volume (ERV) than did non-obese individuals. Although inspiratory capacity was greater in obese men and women, the difference was significant only for the men. In obese men, there was a significant negative correlation, not seen in the women, between waist circumference and FEV 1 . Conclusion:Pulmonary function is altered in women suffering from class I or II obesity. In obese men, although pulmonary function is unaffected by BMI, we observed a significant negative correlation between BMI and ERV. We can conclude that pulmonary function is influenced by waist circumference in men suffering from class I or II obesity.

O objetivo do estudo foi demonstrar o efeito de dois protocolos da estimulação diafragmática elétrica transcutânea (EDET) sobre a força muscular respiratória de mulheres saudáveis, sendo um protocolo segundo Geddes et al. (1988) e outro padronizado pelo equipamento Phrenics. Mulheres saudáveis foram divididas em 3 grupos: Controle (n=7); EDET com Phrenics (n=7) e EDET com Dualpex (n=7), sendo o tratamento realizado 2 vezes por semana, durante 6 semanas (12 sessões). Foram avaliadas a pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx), antes e após o tratamento. A análise estatística foi realizada pelo teste Shapiro-Wilk e Kruskal Wallis com pós-hoc de Dunn (p<0,05). Os dois grupos experimentais apresentaram aumento na PImáx (Phrenics: 32,9%; Dualpex: 63,2%) e na PEmáx (Phrenics: 44,7%; Dualpex: 60,9%), diferentemente do Controle que não apresentou diferença. Em conclusão, os dois protocolos de EDET promoveram aumento da força muscular inspiratória e expiratória em mulheres saudáveis.